The eye disorder Amblyopia is an odd disorder because there is nothing really wrong with the eye.  The fault lies in the way the messages get from the eye to the brain. Research into this eye issue has indeed shown that amblyopia is a disorder of the brain.

If the fault in the eye is prolonged then the brain switches off its connection to that eye so that mixed messages aren’t received that might lead to things such as double vision.

As eyes develop in a child up until the age of two, both eyes work toward gaining connections to the brain and if one eye fails to “gain enough brain space” then the more developed eye takes over the job of providing images, to the detriment of the less developed eye, and gives rise to the term “lazy eye”.

Amblyopia is sometimes confused with another eye disorder called strabismus, which describes the condition of the eyes being misaligned. The confusion comes from the misuse of the term “lazy eye” in describing strabismus.

Symptoms to look for

Symptoms are very difficult to establish since of course very young children are not aware of any seeing deficiency that they may have, and cannot communicate about it.

Although strabismus and amblyopia are different disorders, strabismus being the misalignment of the eyes may itself lead to amblyopia, hence a slightly “crossed eyes” appearance may be an initial symptom.

A really good giveaway symptom is a child becoming annoyed or irritated if one eye that turns out to be the “good eye” is covered, but not so if the “lazy eye” is covered.

Treatment

If the amblyopia was caused by the eyes having different visual capacity, with one eye being either near or farsighted (called a refractive eye error) then it can be treated by optometrist prescription glasses or even contact lenses.

In almost all cases however the use of a cover up patch over the good eye to let the less developed eye catch up in development is a feature of treatment. The covering up process needs to be prolonged for a period of a number of months.

With children of course, the use of an eye patch can be a problem in terms of embarrassment and annoyance. Non-compliant difficult children can benefit from special eye drops to do the job or the use of a designed contact lens that acts as a cover patch but still actually looks normal to others – embarrassment avoided!
Recently an extensive study into patching for amblyopia revealed that only a few hours a day is required to achieve the optimal visual result.  This has revolutionised amblyopia treatment

If the cause of the amblyopia is a strabismus (turned eye) then corrective eye surgery to straighten the eye misalignment can also be an option.

Diagnosing amblyopia

The earlier an amblyopia is detected, the better!

Amblyopia is a disorder, not a disease, that will not cure itself over time, so needs effective treatment.

This is all well and good, but treatment may prove difficult with very young children; testing children’s eyes before the age of 5 or 6 can be difficult.  Without adequate eye testing treatment is likely to be inaccurate.  Luckily specialised paediatric tests do exist that allow treatment to proceed with confidence.